Authors: Katherine Stone
Even though Leslie heard the familiar reassuring noises that undeniably heralded the close of another night on call, her thoughts were not tranquil. She was thinking about the fog. The surprising dense fog outside the window. And the fog inside, the personal fog that had settled, firmly, around her. Again.
Again. It had been there in summer, all summer. But like the San Francisco fog, it had vanished—had been banished by her—in September. It was back now, an enveloping unsummoned presence, because everything had changed. Because maybe it wasn’t impossible anymore. Because she could dare to think about it. About him.
It wasn’t really very complicated. One didn’t need a degree in English to decipher the meaning of the mysterious fog. Even a scientist could make the correct diagnosis, Leslie thought wryly. Even an intern.
The diagnosis was simple: Mark David Collinsworth, M.D.
The alarm sounded noisily, a too harsh intrusion on a pleasant but unremembered dream. Mark groaned and in one motion rolled over and depressed the alarm silence button. As he awakened, Mark realized two things. The first was that he was unusually tired, fatigued beyond the chronic feeling of being sleep deprived. The second realization was even more unusual. Unusual and startling Mark realized that he wasn’t unhappy. His first feeling, preceding consciousness by a few moments, was not the familiar aching sadness that had been with him for the past month.
For the past month. Ever since Janet had left him.
This morning’s feeling was happy and eager and so energetic that it almost erased the fatigue. The feeling was new. Mark had never felt it before. Not even with Janet. Not even in the beginning. Not ever before.
As Mark’s consciousness caught up with the vital feeling that had awakened the instant the alarm sounded, he remembered the cause of the feeling: Kathleen. And he knew why his chronic sleep deficit seemed more acute. Kathleen hadn’t left until three. Only four hours ago she was still in his bed making him feel the way he still felt even after she was gone.
Kathleen. As he showered, Mark thought about her, remembering last night, astonished that he had only known her for a week.
As Mark recalled the events of the past week he resisted any attempt to put meaning to them. He was still reeling from Janet’s angry words, still trying to make sense of Janet’s condemnation of their marriage. Her condemnation of him. For the past month Mark lay awake at night, tired but unable to sleep, wondering how to save his marriage and what he would do if it wasn’t salvageable.
For the past month Mark had taken his life one day at a time. In the few moments he had that weren’t of necessity focused on his patients, he tried to make sense of what happened. He tried to understand the venom of Janet’s words.
One day at a time.
And now there was Kathleen and the wonderful feeling that, for the moment, obliterated the anguish and turmoil about Janet.
One day at a time.
Kathleen.
One night at a time.
Mark met Kathleen on Halloween. Mark was on call on Halloween.
“You are always on call on Halloween,” Janet might have said if they hadn’t separated three weeks before.
Just as she said that he was always “on” on Thanksgiving or Christmas, which was also her birthday, or their anniversary or his birthday. It wasn’t true of course. It was the luck of the schedule. He was always on call every third night, at least. Sometimes every other night. Sometimes those on call nights coincided with real world events like holidays and birthdays and anniversaries.
“Besides,” he would have asked Janet, “what would we do if I was off on Halloween? Go to a party with my friends most of whom you detest?”
That—the way Janet felt about his friends, about medicine—was part of the news she had given him three weeks before.
“I hate your friends and I hate medicine,” Janet had said. Then she added quietly, “And I think you do, too.”
By Halloween there was no Janet, and Mark didn’t care whether he was “on” or “off” on Halloween. Or any other time for that matter. Except that Halloween meant craziness. Halloween was like a full-moon night, only worse. But since Mark was on call for the critical care units at University Hospital, he would probably feel very little of the Halloween impact.
The emergency room, particularly at San Francisco General Hospital, would be hit the hardest by the Halloween phenomenon. There they would see lacerations that were unusually long and deep and old and dirty because of the blood alcohol level of the victim. They would see broken bones, the result of the inevitable conflicts as the traditional Halloween Gay Pride Parade made its way along Castro Street to the jeers and taunts of macho straights. They would see the drug fallout from parties: angel dust freakouts, cocaine-induced headaches and palpitations, and the age-old marijuana death paranoia made worse by the ghoulish costumes on fellow partygoers.
Halloween in the ER was the stuff anecdotes were made of. Anecdotes to tell at parties. To your friends. Medical anecdotes to tell medical friends. Everything Janet hated.
Mark was quite content to be on call for the critical care units instead of the emergency room. His admissions would be legitimately sick, uncostumed, undrugged and uncrazed by the Halloween spirit.
Mark was paged to the emergency room at ten
P.M.
on Halloween.
“We have a fifty-six year old woman with substernal chest pain,” the harried resident told him, “radiating to her left arm, lasting maybe five minutes. Responded to nitro. Has chronic angina but this lasted longer. No EKG changes. Painfree now. Probably just angina, but I’d like to bring her in as a rule out. It’s a soft hit,” the voice trailed off apologetically.
A hit was an admission, any admission. A night with no admissions was a no hitter. A soft hit meant it might be safe to send the patient home, but . . .
Soft hits were fine with Mark. He believed in erring on the side of the patient. It was safest to admit the woman. Just in case.
“Sounds appropriate to me. I’ll be right down to get her. Is it a zoo down there?”
“An unbelievable zoo.”
“Listen, after I get her tucked in, if it’s quiet up here, I’ll be happy to come help.”
“Thanks, Mark. That would be great.”
Mark found that his patient, although sick, sane and undrugged, was in costume. At least her head was. The rest of her was already clad in a bland, standard issue hospital gown. She wore a white wig with perfectly curled ringlets and a diamond tiara. Marie Antoinette, or someone, Mark thought idly, noticing at the same time how lovely, gracious and regal-looking she was. She extended a beautifully manicured and lavishly jeweled hand to him.
“Hello, Dr. Collinsworth,” she said, as if meeting him at a party.
“Hello, Mrs. Jordaine. How are you feeling?”
“Fine, now. Really. No pain. I probably could go home,” she said, but frowned. It was obvious that Mark’s elegant, gracious patient felt uneasy about going home. She was worried. She felt sicker than she looked. The pain must have been worse than she described. The soft hit became a hard one.
“No,” Mark said firmly, “we want you to stay. You’re completely pain free now?”
She nodded and smiled. A voice reached them from behind.
“Mother, I just spoke to Father. Oh, hello! Sorry!” she exclaimed, startled as she opened the curtain surrounding her mother’s monitored bed to find that her mother was not alone.
She was completely in costume. She wore a gray and mauve, floor-length velvet gown studded with tiny pearls and cut low in front, revealing her round, full breasts. Her dark black hair was piled on her head and draped with pearls. Her dark-lashed violet eyes sparkled with surprise and pleasure when she saw Mark.
“Kathleen, this is Dr. Collinsworth, the CCU doctor. Dr. Collinsworth, this is my daughter Kathleen.”
“Hi,” Mark said. She is so beautiful, he thought.
“Hi,” Kathleen said. She glanced at her mother and was relieved enough by how comfortable she looked to spend a moment noticing her mother’s doctor.
The usual clichés, Kathleen thought: tall, dark, handsome. Clichés, she mused.
Tall
. That was easy, a statement of fact. Kathleen embellished it a little. Mark was a perfect height.
Dark
. Completely inadequate to describe the dark brown hair that curled sensuously over his ears and onto his neck or the intense, thoughtful, serious dark brown eyes made darker by the blue-black half circles under them.
Handsome
. Unbelievably, indescribably handsome, Kathleen thought. The whole dark, earnest, strong, romantic package.
Tall, dark and handsome. It didn’t begin to do him justice.
“How’s Mother?” Kathleen asked after a moment.
“Fine,” Mark and Virginia Jordaine answered in unison.
“No evidence of any damage, but we’re going to admit her for two or three days, just to be certain,” Mark explained.
“As a rule out,” Virginia Jordaine explained to her daughter.
Mark looked from beautiful mother to beautiful daughter and arched an eyebrow. A rule out was medical jargon, short for
r
ule
o
ut
m
yocardial
i
nfarction, or heart attack. At some centers such an admission was called a ROMI. During the daily morning report at such centers the resident would say, “We admitted two ROMIs last night.” In San Francisco the resident would say, “We admitted two rule outs.”
Clearly Virginia and Kathleen Jordaine had been to centers favoring the rule out jargon and were familiar with it.
“Dr. Collinsworth walked in just moments before you did, Kathleen, so I haven’t had the chance to give him my past history. I do have legitimate coronary artery disease,” she explained to Mark, “confirmed by angiogram. It’s not severe enough to bypass. Yet. I’m followed at the Atherton Clinic by Dr. Brown. Occasionally my chronic stable angina acts up, and I get admitted as a rule out. Fortunately, I always have ruled out,” she added firmly, a trace of worry in her voice.
Tonight’s episode of pain was different, Mark thought. She’s just not admitting it. Even to herself.
“You’re an excellent historian, Mrs. Jordaine. I’ll give Dr. Brown a call once we get you settled upstairs.”
“We were at a ball at the Fairmont,” Kathleen interjected. “We thought it best to come here rather than to drive all the way to Palo Alto. She usually gets admitted to Stanford Hospital.” Kathleen was as polite and gracious as her mother. They didn’t want to offend anyone, neither Virginia’s usual physician nor Mark.
“You did exactly the right thing. We’ll keep Dr. Brown posted and transfer you to Stanford Hospital in day or two if you like.”
“If my enzymes are normal you’ll just discharge me in two days anyway. So I might as well stay here.”
Mark was a second year resident. He was a year ahead of Leslie and was her supervising resident. As his intern, Leslie assumed primary care of all patients admitted by Mark on his on call nights. Then they managed the patients together, Leslie as intern and Mark as supervisor.
The morning after Halloween, Leslie became Virginia Jordaine’s intern. That afternoon the cardiac enzymes returned slightly elevated, and the electrocardiogram showed minor ST segment changes without Q waves.
“She’s had a very small subendocardial MI. She probably had more than five minutes of discomfort even though she really insisted that was all. She was denying a little last night. I’m sure she’ll give you the whole story, Leslie,” Mark said to her. “No point pushing her because we have the diagnosis. But she needs to understand that whatever she felt and isn’t telling us about is an important warning signal.”
Virginia Jordaine did tell Leslie. It wasn’t a confession. It was simply an amazed appreciation that the weakness she had felt all day long—weakness and heaviness without pain—was her heart.
Kathleen stayed in her mother’s room as much as visiting hours would permit. Between visits she read in the waiting room. William Jordaine returned from New York at the news of his wife’s hospitalization. He visited mostly in the evenings.
Mark decided that Kathleen looked even more beautiful in broad daylight, wearing soft silk blouses and tailored skirts and allowing her long black hair to fall free. Serene, understated, elegant beauty.
Mark and Kathleen saw each other several times every day. Sometimes they would just wave at each other, she sitting in the waiting room and he rushing off to rounds, the ER, the ICU or Radiology. Whenever he could, even for a moment, he would stop to talk. Each day Mark and Leslie met with Kathleen and her parents to discuss Virginia’s progress and the plans. The Jordaines took the news of Virginia’s small heart attack calmly.
“It’s a warning, Mother,” Kathleen said, her voice a little shaky. “You push too hard.”
It was decided that Virginia would remain in the CCU at University Hospital in San Francisco for several days. Then, if stable, she would be transferred to Stanford for the balance of her ten day hospitalization.
During that time Mark and Kathleen learned few facts about each other, but they both knew that they felt good—happy—every time they waved, every time they talked, every time they even caught a glimpse of each other. The warm happy feeling persisted while they were apart, and it was renewed, strengthened, the next time they saw each other.
At eight o’clock the night before Virginia was to be transferred to Stanford, Mark found Kathleen in the visitors’ waiting room. He was on call again but not very busy, not too busy to stop for a moment.
“Hi!” Kathleen smiled. Then a moment of worry flickered. “Is Mother all right?”
“She’s fine. Rock stable. I just wanted to say hi. And goodbye. I may not see you in the morning.”
“Oh,” Kathleen said, frowning slightly. Then she added, “You certainly work hard. You’re here all the time. It must be difficult for your wife.”
Kathleen’s eyes drifted toward Mark’s wedding
ring. It was a plain solid band of eighteen carat gold. Very traditional. Very married.
But he doesn’t act very married, Kathleen thought.